As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
The Credentialing Specialist is responsible for supporting the credentialing program which includes but not limited to ensuring the quality of credentialing of contracted providers in accordance with NCQA (National Committee Quality Assurance) and DHS guidelines.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Completes all initial credentialing and re-credentialing per policies and procedures.
Prepares newly credentialed providers for monthly committee meeting.
Support Delegation Oversight audits as necessary
Assists in answering provider calls.
Assist in responding to provider emails
Prepares Health Plan Submissions as needed
KNOWLEDGE, SKILLS, ABILITIES
Strong communication and interpersonal skills.
Excellent organizational and management skills.
Attention to detail
Knowledge of NCQA/state/federal standards.
Proficient in Database, MS Excel, Word and other software systems.
A team player with multi-tasking capability and strong customer service orientation.
EDUCATION / EXPERIENCE
2-3 experience in physician office or billing office preferred
High School degree or equivalent required; Bachelor degree preferred
Must be able to work in sitting position, use computer and answer telephone
Office Work Environment
Job: Conifer Health Solutions
Primary Location: Encino, California
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005025656
About Conifer Health Solutions
Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.